Urinary estriols: are they of value in normoglycemic diabetic pregnancy?

The purpose of the study was to assess the value of 24-h urinary estriols in the management of diabetic pregnancies. Twenty-seven pregnant diabetic patients (White's class B through R) received insulin dosages twice daily as a combination of NPH and regular insulin. Laboratory and home monitored blood glucose was maintained within the range of 70-150 mg/dl. From 32 wk onward daily 24-h urinary estriols, weekly fetal heart rate monitoring, and, when indicated, amniotic fluid lecithin/sphingomyelin ratio were used to evaluate fetal well-being. Fetal heart rate and amniotic fluid testing were of value while urinary estriols failed to be useful in management or timing of delivery. We conclude that when third-trimester normoglycemia is maintained in pregnant diabetic patients, one obviates the need for the costly and odious task of daily urine estriol measurements.